Three hot-button issues on Nov. ballot in Mass.

Sunday

Jul 15, 2012 at 12:01 AMJul 15, 2012 at 3:04 PM

Massachusetts voters in November could decide whether to provide patients with just months to live the right to obtain lethal prescriptions from doctors. Other ballot questions would give patients with debilitating conditions the opportunity to obtain medical marijuana and provide independent repair shops access to carmakers’ closely guarded data.

David Riley and Michael Morton, Daily News staff

Natick’s Margie Carberry had surprised doctors by living long enough to see her youngest daughter graduate high school, but could no longer watch TV, talk with friends or go for a walk.

Faced with a terminal tumor that kept returning to her spine, she took the only measure of self-determination she felt she had left: She used her marker board to tell family and caregivers that she wanted her feeding tube removed. She died at age 51 last July, six weeks after making her fateful decision.

“If you’ve ever watched anybody go through that process, it’s heart-wrenching,” her husband, Jim Carberry, said recently. “She basically starved herself to death because that was her only option.”

That could change this fall, when Massachusetts voters decide whether to provide patients with just months to live the right to obtain lethal prescriptions from doctors.

Proponents had to deliver more than 11,000 signatures by July 3 to secure a place on the ballot. A spirited campaign is expected for each question.

The “Death with Dignity” campaign started with signatures from the former head of the New England Journal of Medicine, several other Harvard Medical School doctors, and respected lawyers and academics.

Early medical marijuana supporters included a former detective, at least one attorney, a man with Lou Gehrig’s disease, family members of deceased patients and two more Harvard doctors.

But 75 percent of Massachusetts Medical Society delegates opposed physician-assisted suicide last December. In May, 82 percent opposed legalizing marijuana for medicinal use — though in both cases the votes were not specifically aimed at the ballot.

Opposition to the marijuana question is clear, though, from anti-drug groups.

“This is about selling pot in our neighborhoods,” said Heidi Heilman, president of the Massachusetts Prevention Alliance. “That’s the bottom line.”

Death with Dignity

The proposed act would allow doctors to prescribe lethal medication to adults with less than six months to live, with restrictions. It would not legalize euthanasia, meaning patients would have to take the pills themselves. They would likely die within hours.

Before doing so, though, they would have to get a second doctor’s opinion, show capacity to make and communicate health care decisions, and voluntarily express a wish to die on two occasions, 15 days apart. A request would also require two witnesses.

Doctors would have to inform patients of other options and require them to visit a psychiatrist or psychologist if mental health problems are suspected. Participation from medical providers is voluntary, and some practices may choose not to offer the prescriptions.

Catholic church leaders oppose the question on moral grounds, while several groups representing people with disabilities argue that there aren’t enough safeguards for the vulnerable.

Opponent Dr. James Kenealy, a Framingham ear, nose and throat specialist who has seen cancer patients die, said the issue is fraught with moral, philosophical and spiritual questions.

While he thinks colleagues who support the proposal are well-intentioned, he argues that they are ignoring recent advances in controlling pain and providing emotional support at the end of life.

“Now that’s being undone by this push to give someone a pill,” said Kenealy, the former head of the medical society’s legislative committee. “I think it’s a bit of an abdication of our responsibility as physicians.”

But Carberry, a member of Framingham’s Unitarian Church, said his wife had been suffering and should have been afforded that right.

“She wasn’t living,” he said. “She was existing.”

Carberry said it is possible that the act’s safeguards could fail, but he called that unlikely. He said that in Washington and Oregon, where the practice is legal, prescriptions often don’t get used but still provide solace. And while he acknowledged the chance a patient could give up too soon, he pointed to individual liberty.

“The real crux of the situation is giving people the right to control that,” Carberry said.

Medical marijuana

After a challenge by Heilman’s group, the Supreme Judicial Court added clarity to the marijuana question’s wording: Specifically, that the act would license up to 35 nonprofit dispensaries throughout the state, with no more than five per county.

Also, that the Department of Public Health would issue home-growing permits to qualifying patients and their caregivers if travel to a center is infeasible for health reasons or not affordable.

Heilman said her alliance was thrilled the court “ruled to expose the details,” while the Committee for Compassionate Medicine, the backer, also claimed a publicity win.

“The hallmark of this initiative is state regulation,” spokeswoman Jennifer Manley said.

Medicinal marijuana is legal in 17 other states and the District of Columbia, with proponents citing studies that connect marijuana with the management of chronic pain, muscle spasms and nausea.

In Massachusetts, the act would cover patients with a certified, “debilitating” medical condition — with cancer, Parkinson’s and other diseases specifically mentioned but the definition left open for doctors.

Such patients could possess as much as a 60-day supply for their personal use, a standard the Department of Public Health would need to set. The dispensaries would need to register their workers and keep their supplies locked up.

The act would not make doctors prescribe medical marijuana, nor force health insurers or government agencies to pay for it. Fines and jail time would be handed out for violations.

But Heilman believes the law could still be abused and lead to more marijuana use by the larger population, especially among the young.

Kenealy called the proposal a “Trojan horse’’ for a larger goal: treating marijuana like alcohol, through legalization, regulation and taxation. He doesn’t believe doctors should be put in that spot, and thinks the act would bypass normal drug development safeguards.

In its resolution, the medical society called evidence for the safety and efficacy of medicinal marijuana insufficient. But it remained open to the federal government allowing formal research.

Right to Repair

The so-called “Right to Repair” initiative would require vehicle manufacturers to make diagnostic and repair information and tools available for owners and independent repair shops to purchase, such as what certain computer codes mean, when a check for problems is run through the car’s computer.

Proponents say carmakers, which now make this information available only to certified dealers, are preventing independent shops from making routine repairs and forcing owners to get their vehicles fixed at costly dealerships.

But the automakers argue that repair shops already have access to much of the information, with the theft of sensitive data a risk. They also say the law could lead to a decline in the quality of parts used.

(David Riley can be reached at 508-626-4424 or driley@wickedlocal.com.)

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